Re: Rant/was How much would you pay

November 5, 2008

Finally, the makers of Xolair have an assistance

program that can help you with the insurance transition. They may be

able to help you. I didn't ask and found out they would have helped me

avoid the missed dose I had if I had asked.

Dharm

My nurse recommended I talk to Genentech about a " debit card " program when my

copay went for $30 to $200 for a 3-month supply. I felt funny doing it since I

am not a hardship case, but she kept telling me to do it. When I called the

number she gave me, I was told that because I have Medicare Part A (which pays

for nothing), I am ineligible. Blatant age discrimination!

Now I'm not complaining about the $800-a-year out-of-pocket for the medication,

plus the doctor copays for " chemotherapy, " but I know there are others who would

need that assistance, and it won't be available to them because of Genentech's

discriminatory practices.

Does anyone else think the drug companies are raking in money hand-over-fist for

some of these drugs that enhance quality of life? To me, it is immoral that

someone could be charged hundreds or thousands of dollars a month for such

medications. Drug companies can't argue on behalf of R & D since that is not where

the money goes -- they charge what the market will bear, or in other words, what

they feel they can get out of sick people. And they use their profits for drug

pushing and for lobbying.

Sorry, I know this isn't the point of the list, and Xolair is definitely not the

worst medication in which this is practiced. It offends me that drug companies

play off people's health and wellbeing.

Thanks for letting me spout off.

Carol

November 9, 2008

I'm taking Xolair now because I have an employer plan that covers it

for the moment, but they're hiking up the copays big time and in the

not-to-distant future I'll retire and have to depend on Medicare

anyway so I'll be turning to other medications, even if less

effective.

The phenominal amount drug companies are charging for some of these

medications smacks of greed and you see where that finally got Wall

Street. What we see now is capitalism crumbling because the

regulators didn't regulate and without regulation the capitalists

becoame intoxicated with greed.

They say the pendulum doesn't stop in the middle. Socialism is the

other side of the swing and the big bailout of our financial system

(effectively nationalization of the banking system) and latest

election suggests we may be there sooner than later.

Socialism and nationalization of the pharmeceutical industries may be

just what the Doctor ordered for the millions of baby-boomers

starting to retire and have to live on shriveled 401K's whose very

investments helped fund the drug companies.

--- In , Carol Corley <floridabouvs@...>

wrote:

>

> Finally, the makers of Xolair have an assistance

> program that can help you with the insurance transition. They may

be

> able to help you. I didn't ask and found out they would have helped

me

> avoid the missed dose I had if I had asked.

> Dharm

>

> My nurse recommended I talk to Genentech about a " debit card "

program when my copay went for $30 to $200 for a 3-month supply. I

felt funny doing it since I am not a hardship case, but she kept

telling me to do it. When I called the number she gave me, I was told

that because I have Medicare Part A (which pays for nothing), I am

ineligible. Blatant age discrimination!

> Now I'm not complaining about the $800-a-year out-of-pocket for the

medication, plus the doctor copays for " chemotherapy, " but I know

there are others who would need that assistance, and it won't be

available to them because of Genentech's discriminatory practices.

> Does anyone else think the drug companies are raking in money hand-

over-fist for some of these drugs that enhance quality of life? To

me, it is immoral that someone could be charged hundreds or thousands

of dollars a month for such medications. Drug companies can't argue

on behalf of R & D since that is not where the money goes -- they

charge what the market will bear, or in other words, what they feel

they can get out of sick people. And they use their profits for drug

pushing and for lobbying.

> Sorry, I know this isn't the point of the list, and Xolair is

definitely not the worst medication in which this is practiced. It

offends me that drug companies play off people's health and wellbeing.

> Thanks for letting me spout off.

> Carol

>

November 10, 2008

Thanks for all the advice about Medicare coverage.

In summary, what I see is that Xolair would run me up to, through and

then beyond the Part D donut hole real quick. Since I don't have a

doctorate degreee in calculating Part D costs I estimate the costs as

follows:

Annual charges up to and through the donut hole = $3000

Annual charges beyond the donut hole for 5% catastrophic copay = $1000

Annual Medicare part D premium = %400

Total annual cost for Xolair = $4400

Then we're probably looking at another $500 in catastropic copay

coverage (thet's the 5% copay beyond the donut hole) for other

prescription drugs. So:

Total annual cost for all medications = $4900.

So a retiree with a devastated 401K plan living mostly on Social

Security will probably have to choose between food and medicine

unless they want to take up residence under a bridge somewhere to cut

down on housing costs.

Me ... well I'll learn to do without Xolair since I hate all that

freeway noise.

> >

> > Finally, the makers of Xolair have an assistance

> > program that can help you with the insurance transition. They may

> be

> > able to help you. I didn't ask and found out they would have

helped

> me

> > avoid the missed dose I had if I had asked.

> > Dharm

> >

> > My nurse recommended I talk to Genentech about a " debit card "

> program when my copay went for $30 to $200 for a 3-month supply. I

> felt funny doing it since I am not a hardship case, but she kept

> telling me to do it. When I called the number she gave me, I was

told

> that because I have Medicare Part A (which pays for nothing), I am

> ineligible. Blatant age discrimination!

> > Now I'm not complaining about the $800-a-year out-of-pocket for

the

> medication, plus the doctor copays for " chemotherapy, " but I know

> there are others who would need that assistance, and it won't be

> available to them because of Genentech's discriminatory practices.

> > Does anyone else think the drug companies are raking in money

hand-

> over-fist for some of these drugs that enhance quality of life? To

> me, it is immoral that someone could be charged hundreds or

thousands

> of dollars a month for such medications. Drug companies can't argue

> on behalf of R & D since that is not where the money goes -- they

> charge what the market will bear, or in other words, what they feel

> they can get out of sick people. And they use their profits for

drug

> pushing and for lobbying.

> > Sorry, I know this isn't the point of the list, and Xolair is

> definitely not the worst medication in which this is practiced. It

> offends me that drug companies play off people's health and

wellbeing.

> > Thanks for letting me spout off.

> > Carol

> >

November 10, 2008

You have a good pulse on how many people feel. I am fortunate that I

have a secure job with an employer which provides good insurance.

Still, I notice that United Healthcare my current insurer last year

placed most asthma drugs including Advair in the THIRD tier. In my

plan, that means $50 a months co-pay retail, and $125 month co-pay

for up to 90 days via mail order! That means $500 a year for an astma

maintenance drugs. Assuming someone takes Advair alone that's $500 a

month. Add to that Singulair or other asthma drugs and the total for

a patient can easily exceed a $1,000. I can afford that amount, but

I know many patients with chronic asthma simply cannot afford

thousands of dollars in out of pocket. In my case, this scenario is

before I begin paying for Xolair which at a 10% coinsurance rate

means I pay $112 per dose until I hit the catostraphic limit. I wrote

a letter to United Healthcare's President about the issue of high co-

pays and as expected did not recieve a response. For many working

poor and middle class who HAVE insurance, healthcare is becoming

unaffordable.

For people like me, it means shorter vacations or putting off buying

a bigger condo after getting married. Basically, I eat about $3,000

out of pocket before all my costs are picked up under my High

Deducutible Health Plan (HDHP) and that's with a very low $6,000 out

of pocket maximum. The more typical limit is at or near the IRS

mandated limit which is in excess of $10,000 for family coverage! For

people who live paycheck the transition to High Deductible Health

Plans means they simply go without drugs that not only improve the

quality of their lives but may actually save their lives.

This is the situation for those who are employed and recieve their

coverage through their employers. I can't tell you how depressing it

is to see what happens to self employed people get sick. My advice to

anyone with chronic disease is to get a secure job with good health

insurance and stick it out. I some people don't like or even detest

the idea of working a nine to six job, but as someone who has been

self employed and in the individual health insurance market, DONT DO

IT! You may not like the idea of taking orders and going into work

everyday, but the being without insurance with a chronic disease like

asthma is worse in the long run.

Dharm Guruswamy

--- In , " mister_manganese " <barryb@...>

wrote:

>

> I'm taking Xolair now because I have an employer plan that covers

it

> for the moment, but they're hiking up the copays big time and in

the

> not-to-distant future I'll retire and have to depend on Medicare

> anyway so I'll be turning to other medications, even if less

> effective.

>

> The phenominal amount drug companies are charging for some of these

> medications smacks of greed and you see where that finally got Wall

> Street. What we see now is capitalism crumbling because the

> regulators didn't regulate and without regulation the capitalists

> becoame intoxicated with greed.

>

> They say the pendulum doesn't stop in the middle. Socialism is the

> other side of the swing and the big bailout of our financial system

> (effectively nationalization of the banking system) and latest

> election suggests we may be there sooner than later.

>

> Socialism and nationalization of the pharmeceutical industries may

be

> just what the Doctor ordered for the millions of baby-boomers

> starting to retire and have to live on shriveled 401K's whose very

> investments helped fund the drug companies.

>

November 10, 2008

Are you sure? My doctor's office said that for Medicare patients, they have to

front the cost of the medication and then be reimbursed, and they are choosing

to not do that.

Carol

Leigh wrote:

when you retire and are on medicare, you will also obtain a drug coverage policy

er from a provider it will cover xolair. you will probably pay for one month's

worth a year while you are in the donut hole aka gap period.

November 11, 2008

Well things might change in the next four years if all those

Democrats taking over the government are pushed to nationalize the

pharmaceutical industry. I wouldn't rule it out. The tail

shouldn't be wagging the dog.

> >

> > I'm taking Xolair now because I have an employer plan that covers

> it

> > for the moment, but they're hiking up the copays big time and in

> the

> > not-to-distant future I'll retire and have to depend on Medicare

> > anyway so I'll be turning to other medications, even if less

> > effective.

> >

> > The phenominal amount drug companies are charging for some of

these

> > medications smacks of greed and you see where that finally got

Wall

> > Street. What we see now is capitalism crumbling because the

> > regulators didn't regulate and without regulation the capitalists

> > becoame intoxicated with greed.

> >

> > They say the pendulum doesn't stop in the middle. Socialism is

the

> > other side of the swing and the big bailout of our financial

system

> > (effectively nationalization of the banking system) and latest

> > election suggests we may be there sooner than later.

> >

> > Socialism and nationalization of the pharmeceutical industries

may

> be

> > just what the Doctor ordered for the millions of baby-boomers

> > starting to retire and have to live on shriveled 401K's whose

very

> > investments helped fund the drug companies.

> >

>

November 12, 2008

I met with my new primary care physician today who was quite

interested in my Xolair treatment and severe asthma. Actually, I

stopped it 4-1/2 months ago because they required that I go to an

infusion center which was too many $, too much time, too incompetent,

dirty, and with terminal patients all around me. I'm glad that my

pulmo got me onto Xolair but the politics eventually ended my

treatment.

But, on to the topic related to this thread ... I said I had self

injected for well over a year and am bright and well educated with no

problems w/self injection. It came out very clearly that there is

sooooo much money to be made on Xolair and other monoclonal

antibodies that a clinic is not going to let a patient slip thru

their hands when they can collect that kind of big bucks

administering to the patient in-house. That made a lot of sense

because it is NOT required by the FDA that a patient be injected in a

clinic. It IS recommended but not required. It's the same with

Genentech - it is not a requirement - just lots of dollars to the

docs and clinics who administer in-house. I was surprised and amused

by his frankness. He actually started to suggest I come there but

the distance is even greater plus ... I do not do clinics for

Xolair. Genentech (and other pharmaceutical companies as Genentech

is not the only one) and clinics are in bed together for $$$$ but I'm

not.